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This recent study is both hopeful (90% chance that your MS will not be too aggressive) and sobering (well, there's the other 10%). And, no surprise, I was in the danger wheelhouse: older (36 at diagnosis) and male. But I've never smoked--the last key in this trifecta.
My mom always said I was a rare bird. This is a time I wish I was in the majority! Heck, at least it gives me more to talk about from a first-person perspective.... - Dave
Neurology. 2011 Jun 7;76(23):1996-2001.
Demographic and clinical characteristics of malignant multiple sclerosis.
Gholipour T, Healy B, Baruch NF, Weiner HL, Chitnis T.
Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's
Hospital, 1 Brookline Place, Suite 602, Brookline, MA 02445
tchitnis@partners.org.
OBJECTIVE: Multiple sclerosis (MS) that causes patients to require assistance for
ambulation (Expanded Disability Status Scale [EDSS] ≥6) within 5 years from
symptom onset is generally termed malignant. Malignant status can be transient
(TM) or sustained until year 5 (SM). We studied the incidence, predictors, and
demographic and clinical characteristics of malignant MS.
METHODS: Patients with symptom onset in 2002-2005 and 5-year follow-up were
selected from the Partners Multiple Sclerosis Center database. Patients with TM
were further grouped into TM and SM. The mechanism of reaching EDSS 6 (relapse-
vs progression-related) was determined.
RESULTS: A total of 487 patients were included (17 TM, 42 SM). The incidence
proportion of ever malignant (EM = SM+TM) was estimated as 12.11% and SM as
8.62%. Patients with older age at onset, male gender, and positive smoking
history were more likely to become SM. Compared to nonmalignant patients, the
proportion of progressive-onset MS in the SM group was significantly higher, but
not different in TM. Within relapsing-onset patients, most of TM, and a smaller
proportion of the SM group had a relapse-related as opposed to
progression-related mechanism. The final model predictors for EM vs nonmalignant
were older age at onset, motor symptoms at onset, and progressive disease onset.
Within the malignant patients, predictors of TM vs SM were younger age and
brainstem symptoms at onset.
CONCLUSIONS: Over 10% of patients with MS experience a malignant course as
defined above. Some demographic and clinical factors are found to predict a
malignant outcome. MS in patients who reach a high EDSS based on disease
progression is more likely to remain malignant.
My mom always said I was a rare bird. This is a time I wish I was in the majority! Heck, at least it gives me more to talk about from a first-person perspective.... - Dave
Neurology. 2011 Jun 7;76(23):1996-2001.
Demographic and clinical characteristics of malignant multiple sclerosis.
Gholipour T, Healy B, Baruch NF, Weiner HL, Chitnis T.
Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women's
Hospital, 1 Brookline Place, Suite 602, Brookline, MA 02445
tchitnis@partners.org.
OBJECTIVE: Multiple sclerosis (MS) that causes patients to require assistance for
ambulation (Expanded Disability Status Scale [EDSS] ≥6) within 5 years from
symptom onset is generally termed malignant. Malignant status can be transient
(TM) or sustained until year 5 (SM). We studied the incidence, predictors, and
demographic and clinical characteristics of malignant MS.
METHODS: Patients with symptom onset in 2002-2005 and 5-year follow-up were
selected from the Partners Multiple Sclerosis Center database. Patients with TM
were further grouped into TM and SM. The mechanism of reaching EDSS 6 (relapse-
vs progression-related) was determined.
RESULTS: A total of 487 patients were included (17 TM, 42 SM). The incidence
proportion of ever malignant (EM = SM+TM) was estimated as 12.11% and SM as
8.62%. Patients with older age at onset, male gender, and positive smoking
history were more likely to become SM. Compared to nonmalignant patients, the
proportion of progressive-onset MS in the SM group was significantly higher, but
not different in TM. Within relapsing-onset patients, most of TM, and a smaller
proportion of the SM group had a relapse-related as opposed to
progression-related mechanism. The final model predictors for EM vs nonmalignant
were older age at onset, motor symptoms at onset, and progressive disease onset.
Within the malignant patients, predictors of TM vs SM were younger age and
brainstem symptoms at onset.
CONCLUSIONS: Over 10% of patients with MS experience a malignant course as
defined above. Some demographic and clinical factors are found to predict a
malignant outcome. MS in patients who reach a high EDSS based on disease
progression is more likely to remain malignant.
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